Second Episode of Skin Bends

Please register or login

Welcome to ScubaBoard, the world's largest scuba diving community. Registration is not required to read the forums, but we encourage you to join. Joining has its benefits and enables you to participate in the discussions.

Benefits of registering include

  • Ability to post and comment on topics and discussions.
  • A Free photo gallery to share your dive photos with the world.
  • You can make this box go away

Joining is quick and easy. Log in or Register now!

I'd also be interested in knowing more about "you". Body type, diet, smoker etc? And what else you do when you're away... booze, sleep habits etc.

But for sure get checked out for a PFO. There are reasons to get it fixed outside of diving.

Not a smoker. 5'2'' and 160lbs (but I carry it well :wink:). I would say I'm pear shaped but morphing into an apple the older I get. I did try to pay attention to hydration since it may have been a contributing factor last time. I do have a cocktail at night while on vacation but not excessive. I'm a 61 yr old female so sleep is elusive :D.

I tend to eat well. Not a lot of junk food. Not a lot of snacking between meals but I do enjoy carbs. Not a keto gal.
 
If I might ask, when you say “dive conservatively” exactly what did you do?
 
Were the tanks analyzed to confirm they had the right mix?
 
I didn't take pic's this time around. I did in 2017 but I no longer have them. The rash was light. Not the large purple welts I saw in pictures of people with a much worse case. Mine was almost like hives, predominately on my torso. The symptom that first got my attention was the deep ache in my breasts. That's how it started last time.

Thanks for the description. May I ask who diagnosed you, and how they concluded that it was DCS?

If what you were suffering from was DCS, hive-like skin rash is more suggestive of type I skin bends. This is differentiated from type II (cutis marmorata). Breast pain in DCS would be associated with lymphatic DCS, which is also a type I symptom. Without pictures of the rash it would be hard to tell though. Neither is associated with PFO.

Best regards,
DDM
 
...Neither is associated with PFO.
Excuse my ignorance, why is that? I assumed a PFO would make any/all presentations of DCS more likely by slowing the overall rate of nitrogen elimination from the body.
 
Excuse my ignorance, why is that? I assumed a PFO would make any/all presentations of DCS more likely by slowing the overall rate of nitrogen elimination from the body.

I'm not trying to answer this for him but maybe steer towards a better explanation of the whys of skin bends as I've seen 4-5 cases of that here in Cozumel.

My understanding: A PFO allows bubbles to cross from the venous side to the arterial side of the heart, sending bubbles back out to travel thru the body verses thru the lung "filter".

Skin bends is more associated to lack of off gassing caused by tissues with low circulation or vascular restriction, like being cold at the end of a dive.

Again, that's my understanding and hopefully he'll clarify that - skin bends is a peak curiosity because I've seen it so many times, they seem "undeserved" and we tend to take people on long dives.....
 
Excuse my ignorance, why is that? I assumed a PFO would make any/all presentations of DCS more likely by slowing the overall rate of nitrogen elimination from the body.

Great question! The amount of blood that a PFO allows to bypass the pulmonary circulation in a diver is not clinically significant and so doesn't affect nitrogen elimination in that way. The concern is that venous gas emboli (venous bubbles), which are frequently present in divers and are almost always asymptomatic, could pass through the PFO into the left atrium of the heart and then into the arterial circulation. If that happens, there's a possibility that they will mechanically obstruct the blood flow to certain areas of the body. PFO is associated with sudden-onset severe neurological (brain and spinal cord) DCS, inner ear DCS, and cutis marmorata/skin marbling/type II skin bends.

Best regards,
DDM
 
I had my first diagnosis 3 years ago in Cozumel. I was diving air. Since then, I've been diving nitrox, not on air tables. I was nervous about not knowing my tissue loading so set my computer for the correct mixture and made sure to dive very conservatively. I'm a recreational, vacation diver so we only have a chance to dive twice/year. I have not had a recurrence until this week.

I was back in Coz over Thanksgiving and once again, on my 4th day of diving had the exact same symptoms. My Nitrox mix was 32 on my first dive and 36 on my second. My first dive of the trip was a max of 80' but didn't stay long. I much prefer the tops of the reefs and generally hang out between 45'- 30'.

I decided to see a dive med Dr. when we got home but can't find one in my area. I'm wondering if I should be evaluated for a PFO. If it turns out I have one what does that mean? Can it be repaired? I love diving and don't want to give it up. I would be happy to limit my dive depths since I prefer a shallower dive anyway.

Are skin bends a precursor to something worse or only if you ignore it and keep diving? I'm 61 and have more adipose tissue than I would like :) Honestly, it's probably not going anywhere. Not horribly overweight, just...soft.
Another thought.

Diving Nitrox don't prevent DCI if your still diving to the none deco time limits.
 
I’ve had a couple of hits of skin bends over the years, despite following my computer conservatively. I saw a diving doctor about it and he told me I could do all the tests to see if I had a hole in my heart, or just take it easy and dive more conservatively. I feel a bit “fizzy” if I do three dives a day now, so I try to keep it to just two.
I spoke with an old diver who’s been around since the dark ages and he said back in the day before computers it was very common and they would just stay out of the water for a week or two.
I know that it’s a bit of a worry to get skin bends, but I haven’t noticed any long term after effects. I still dive every day, take one day off each week.
 
Not a smoker. 5'2'' and 160lbs (but I carry it well :wink:). I would say I'm pear shaped but morphing into an apple the older I get. I did try to pay attention to hydration since it may have been a contributing factor last time. I do have a cocktail at night while on vacation but not excessive. I'm a 61 yr old female so sleep is elusive :D.

I tend to eat well. Not a lot of junk food. Not a lot of snacking between meals but I do enjoy carbs. Not a keto gal.

So while nothing here is a super high risk factor, your gender, age and body type are all contributing factors in my opinion. The way you added "not excessive" in the one comment suggests that "a cocktail" is perhaps a couple or three? That in turn perhaps leads to less sleep etc.

As a 65 year old dude, I'm the first to recognize that you can't do anything about most of this stuff, and are likely "disinclined" to deal with the issues that are somewhat controllable. What that means is that you really need to dive conservatively. I believe you said you are diving nitrox, but also setting your computer to that gas... so in other words, there is no safety factor in that. (Just extended time, before hitting the NDL, but if you're diving to that limit, there's no advantage). You might leave your computer set at air, and just be aware of the depth limitations of your gas.

As a semi-educated guess, I don't know that these hits are necessarily unearned. There are enough "risk factors" in your description, and coupled with multiple dives, over several dives, that all this stuff kind of adds up. Perhaps consider modifying your dive schedule. If you do three dive days, perhaps take ever second afternoon off and hit the beach. Or skip the third day altogether just to truly offgas. Even when a computer says you're "clear", it doesn't mean you have zero additional N2 in your system.
 

Back
Top Bottom